Facts about Arthritis & Treatment

Arthritis is a general term, derived from Greek words arthro-, meaning “joint” and – itis, meaning “inflammation.” It refers to inflammation or degeneration of one or more joints characterised by pain, swelling and often stiffness.

It mostly affects the hip, knee, spine or other weight-bearing joints and even the fingers and other non-weight-bearing joints. there are numerous types of arthritis, each having its own symptoms and risk factors. 

The symptoms of arthritis usually develop over time. Adults over the age of 65 commonly experience arthritis, but children, teens and younger adults may develop this chronic disease. Arthritis is more common in females than males and people who are overweight.

Affecting more than 180 million people in India, living with arthritis can have a debilitating impact on those who live with the condition.  Severe arthritis often affects the quality of life and makes it difficult for you to walk or perform routine tasks.



Symptoms and signs of arthritis might vary depending on the type you have.

  • Pain and tenderness
  • Swelling
  • Redness
  • Decreased range of motion of the joints
  • Stiffness
  • Increased fatigue and energy depletion
  • Weakness and muscle wasting
  • Lumps and bumps (nodules and nodes)
  • Fever (in Rheumatoid Arthritis)


  • Age: Risk of developing arthritis (Osteoarthritis, Rheumatoid arthritis and Gout) can increase with age.
  • Gender: SLE, RA are more prevalent in women while Gout are common in men. 
  • Family history: Some types of arthritis run in families.
  • Joint injury or repetitive use: Post-traumatic or secondary arthritis can occur if a physically injured joint does not heal properly
  • Obesity: puts stress on joints, particularly your knee, hips and spine.
  • Crystal deposition
  • Infection



An appointment with Orthopaedic doctor may lead to faster diagnosis and treatment.  You need to inform about your symptoms, medical and family history, social history and lifestyle changes to receive an accurate diagnosis of arthritis. 

A physical examination is needed to evaluate any visible signs and symptoms that point towards arthritis like development of fluid around the joints, warm or red joints and limited range of motion of joints. . 

The Analysis of different types of body fluids (Blood, Joint fluid & Urine) can help to pinpoint the type of arthritis.

Imaging studies like X-rays of affected joints can show cartilage loss, bone damage and bone spurs. It may not reveal early arthritic changes but often used to track progression of disease.

Computed tomography (CT), Magnetic resonance imaging (MRI) is used in specific conditions for detailed bone and surrounding soft tissues structures.


Arthritis may get worse if left untreated.  The challenge is to live with the severity of disease and the goal is to maintain physical ability by slowing disease progression, to stave off physical and functional limitations and reduce pain. 

Treatment may include medications, injections, physical therapy, heating pads, ice packs and surgery.  Arthritic patients often use assistive devices like canes or walkers to take pressure off the sore joints.


  • Lifestyle Changes: 
  • Maintaining a healthy weight reduces the risk of developing osteoarthritis
  • Choose a nutritious diet with lots of antioxidants such as fresh fruits, vegetables, herbs, fish and nuts to lessen inflammation of joints
  • Eat calcium rich foods to protect bone health and gluten-free diet to prevent progression of         disease
  • Minimize or avoid fried and processed foods, high intake of meat and dairy products
  • Reducing stress may help calm the pain and stiffness associated with arthritis
  • Exercise regularly as staying active will keep your joints flexible.
  • Get enough rest and sleep to manage pain effectively
  1. Medications that treat arthritis:
  •  Analgesics such as opioid derivatives (Tramadol, oxycodone or Hydrocodone) or acetaminophen (Tylenol) are effective for pain management but have no effect on inflammation
  • NSAIDs (Ibuprofen, Diclofenac or Etoricoxib)reduce both pain and inflammation
  • Counterirritants like menthol or capsaicin creams interfere with the transmission of pain signals from your joints.
  • Immunosuppressants like prednisone or cortisone help reduce inflammation
  • Disease-modifying anti-rheumatic drugs(DMARDs) – used for treatment of RA or Sero-negative arthritis. It slows or stops the progression of disease.
  • Biologic response modifiers (Etanercept, Infliximab) – genetically engineered drugs that target various protein molecules which are involved in the immune response.
  1. Physical therapy:
  •  Physical therapy involves exercises that help strengthen the muscles around the affected joint and improve range of motion.


    4.Surgery: Surgery is indicated when conservative measures don’t help.

  • Joint repair – in few cases, joint surface can be smoothened or realigned to reduce pain and improve function
  • Joint Replacement – this procedure removes the damaged part of joint and replaces it with an artificial one. Commonly replaced joints are Knee, Hip, Shoulder and Ankle. Knee Replacement is actually just a surface arthroplasty where damaged surfaces of knee bones are resurfaced with artificial ones.
  • Joint fusion – rarely done for large joints due to loss of movement in this procedure. It is more often used for smaller joints like wrist, ankle fingers.



  1. Osteoarthritis:

Most common type of arthritis, which involves wear and tear damage of joints cartilage. It usually happens with age (late 40s or older ) but can develop even in 30s.


  • Painful, swollen and stiff joints after repeated use
  • Once the cartilage lining starts to roughen and thinning out, stress on the tendons and ligaments cause swelling and form bone spurs called osteophytes
  • Due to severity of cartilage loss bones can start to rub together and alter the shape of the affected joint
  • Joints that bear weight as spine, knees and hip joints are affected


Symptoms initially managed with regular exercise, good postures, losing weight, wearing suitable footwear, physiotherapy and painkillers. Once progress to arthritic stage, surgery is required.


  1. Rheumatoid arthritis (RA):


An autoimmune, chronic inflammatory disease, occurs when the immune system does not work properly and attacks the joints or other parts of the body.   Here the lining of the joint becomes inflamed, causing damage to joint tissue. Injured tissue brings on :-

  • Chronic and enduring pain,
  • loss of balance and deformity.
  • Morning stiffness,
  • Fatigue,
  • On & off mild to moderate fever,
  • Numbness, warmth, burning and tingling of hands and feet
  • Symmetrical joint involvement
  • Serious complications of organ systems like rheumatoid nodules, Sjögren’s syndrome, pericarditis, vasculitis, pleuritis, chronic obstructive pulmonary disease (COPD) and scleritis can occur.

Treatment includes medications which slow disease and prevent joint deformity, called disease-modifying anti-rheumatic drugs (DMARDs) and biological response modifiers (biologics).


  1. Juvenile arthritis (JRA):


Juvenile arthritis, an autoimmune condition, is used for joint and rheumatic diseases that affect children and teens and cause hip joint pain and swelling.

  • Oligo-articular JRA :- It affects most commonly the knees, ankles and wrists and children develop eye problems, so regular eye tests with an ophthalmologist are recommended.
  • Polyarticular JRA, or polyarthritis is often accompanied by a rash and a high temperature of 38C (100.4F) or above.
  • Systemic onset JRA begins with symptoms such as a fever, rash, lethargy and enlarged glands. Later on, joints can become swollen and inflamed
  • Enthesitis-related arthritis affects older boys or teenagers causing pain in the soles of the feet, around the knee and hip joints

 Treat with oral steroids such as prednisone, DMARDs and biologics.




Spondyloarthritis or seronegative arthritis commonly affects the spine, sacro-iliac and hip joints.  The most common form is ankylosing spondylitis which occurs when inflammation leads to calcium forming around the ligaments of the spine. This may lead to the vertebrae fusing together.

  • Pain and stiffness, especially in your lower back
  • Can attack peripheral joints (hands and feet)
  • Redness and pain in the eyes (uveitis or iritis)
  • Skin rash
Bone fusion causing deformation of your spine and dysfunction of your shoulders and hips


5.Systemic lupus erythematosus (SLE): 

Lupus is a chronic autoimmune disease, where healthy tissues are attacked by our own immune system. It causes joint inflammation in both the hips at the same time and may affect any organ including the skin, heart, lungs and kidney. 

  • Painful, swollen joints in the feet, legs, hands, around the eyes
  • Mouth sores
  • Sun sensitivity
  • Hair loss
  • Fatigue, headaches and weakness
  • Rashes on cheeks and malar rash
  • Blood disorders, like anemia and low levels of white blood cells or platelets
  • Chest pain due to inflammation of the pericardium or pleura


NSAIDs, corticosteroids, hydroxychloroquine and BLyS-specific inhibitor are used to manage flares.



    Gout, a buildup of uric acid crystals in a joint, is intensely painful.

  • Sudden onset of severe pain, tenderness, stiff, warmth, redness, swelling from inflammation of the affected joint.
  • Typically affects the joints towards the ends of the limbs –toes, ankles or fingers.


In addition to analgesics and anti-inflammatory medications, gout may be treated with specific medication.


7.Infective (Septic) arthritis:  

A painful infection of the joint caused by bacteria, viruses, parasites or fungi. 

It can start in another part of your body and spread to your joints and is often accompanied by a fever and chills.  It usually occurs in only one joint. 

Symptoms come on rapidly like: –

  • Intense swelling, pain, and redness of the involved joint with high grade fever and chills
  • Strikes the knee (mainly), hips, ankles and wrists

It must be treated as emergency procedure and may need surgery. It may need prolonged culture specific antibiotics. Usually a joint aspiration will confirm the diagnosis and also will give opportunity for sending the sample for Culture and sensitivity so that a specific suitable antibiotic can be given. When joint fluid is drained by injection or joint exploration surgery to remove infected synovial fluid, it relieves pain, reduces inflammation and prevent further damage to the joint.

8.Reactive arthritis:


Causes inflammation, pain and swelling of the joints and may develop after an infection in the bowel or genital areas. The infection causes activity in the immune system. 



  • Inflammation of the joints, eyes and urethra (the tube that urine passes through)


9.Psoriatic arthritis: 

Causes skin lesions predominantly and may affect joints of fingers, knees, ankles or elbows (peripheral arthritis) and also back pain.




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